9 January 2020
During a routine inspection
Chesapeake House is a residential care home, registered to support 11 adults, in an adapted building over two floors. The property is two houses converted which was registered before the
Registering the Right Principles were adopted. Chesapeake House is registered to provide accommodation for persons who require nursing or personal care, for adults with learning disabilities. Personal care was also provided for up to four people who were supported to live more independently in individual flats in supported living settings, which were located on the same site.
At the time of our inspection, 11 people were receiving residential care which included one person living in the individual flats on the same site. A further three people were living in the flats, not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. One person was in receipt of personal care when we visited.
The service had not fully been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people. However, the size of the service having a negative impact on people was not fully mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were was an identifying sign and industrial bin outside to indicate it was a care home.
People’s experience of using this service and what we found
The providers quality monitoring systems were not effective to monitor the quality of care provided and to drive improvement. The provider lacked oversight in reporting all incidents. Risk guidance to keep people safe was not always detailed to ensure staff knew what action to take should a person become unwell. Window restrictors were still not fitted to the windows on the second floor, to prevent accidents. People's safety was not protected by the provider's recruitment practices, as not all pre-employment checks were carried out. Support plans and risk assessments were not always in place to ensure people’s needs could be consistently met.
We recommend the provider assesses the environment both internally and externally to ensure there are no hazards for people with limited mobility.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Staff received an induction, ongoing training and support to discuss their work and developmental needs. However, staff had not received training relevant to the needs of the people at the service.
People told us they felt safe at Chesapeake House. Staff understood their responsibility to safeguard people from harm and knew how to report concerns.
People were supported to maintain relationships with people important to them. Staff were caring in their approach and had good relationships with people. Staff treated people with respect and their dignity and privacy was respected. People were supported by staff to maintain their independence.
People were supported to maintain their health and well-being and had access to healthcare professionals such as GP's when required. People were supported to eat and drink enough to maintain a balanced diet.
Refreshments were available to people throughout the day. People and their representatives were involved in their care to enable them to receive support in their preferred way. People were supported to access local community facilities to enhance their well-being.
The provider's complaints policy and procedure was accessible to people who used the service and their representatives. Peoples representatives knew how to make a complaint. Relatives and staff felt they could approach the registered manager if they had any concerns.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 11 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
During this inspection, we identified one breach of the Health and Social Care (Regulated Activities) 2014. This was in relation to the governance of the service. A breach of the Care Quality Commission (CQC) (Registration) Regulations 2009 was also identified relating to notifying CQC of incidents.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least Good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.